Provider Demographics
NPI:1457464372
Name:PHAM, LAURA T L (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:T L
Last Name:PHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:20 YORK ST CB-2041
Mailing Address - Street 2:YNH MEDICAL SERVICES PC
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06404
Mailing Address - Country:US
Mailing Address - Phone:203-688-4748
Mailing Address - Fax:203-688-4740
Practice Address - Street 1:20 YORK ST CB-2041
Practice Address - Street 2:YNH MEDICAL SERVICES PC
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06404
Practice Address - Country:US
Practice Address - Phone:203-688-4748
Practice Address - Fax:203-688-4740
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2008-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT043672207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine